Applicable Discounts

Select all that apply. Please note second sibling discount and GPA discount cannot be combined.

5% GPA Discount - Eligible for NEW students who have earned a 3.8 GPA or higher on their most recent report card and RETURNING students who have earned a 3.7 GPA or higher on their most recent report card (must be submitted to qualify).

School-Parent Understanding

When authorized people noted on this emergency form cannot be reached, my signature gives school personnel my permission to take whatever action is reasonable and appropriate under the circumstances for the welfare of my child.
My signature also authorizes the school district to place this health information on a confidential medical list and/or in a secure database. This information may be shared with educational staff as needed.

Consent Form

Please complete all required fields.

Photography Release

By selecting YES, you consent to the following:

I, the undersigned, do hereby consent and agree that WISE ACADEMY, its employees, or agents have the right to take photographs, videotape, or digital recordings of my child (listed above) in any and all media, now or hereafter known, and exclusively for the purpose of the school website, Facebook, Instagram, promotional videos, yearbook, newspaper, brochures or other printed publications produced by WISE ACADEMY. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. This release will remain as long as my child is attending WISE Academy.
I do hereby release to WISE ACADEMY, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that WISE ACADEMY is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. *

Yes, I give my consent.

No, I do not give WISE Academy permission to use my child's photograph's for school-related or other purposes.

Transportation Waiver

Please select one: *

YES, I, the undersigned, do hereby consent and agree that WISE ACADEMY, its employees, volunteers, and supervisors have the right to transport my child to and from the building periodically for school-related trips.

NO, I do not give permission for WISE ACADEMY to transport my child. I understand that my child will remain & be supervised at the WISE facility for the regular days and continue academic work there unless the trip takes place during non-school time.

Liability Waiver

By signing this form, I agree to release WISE ACADEMY employees, volunteers, and supervisors from any and all damages and hold harmless, except for those that result from gross negligence or wanton and willful misconduct. Should it be necessary for my child to have medical treatment while participating in WISE-related trips, and I cannot be reached, my signature gives WISE personnel permission to use their judgement in obtaining medical treatment deemed necessary and appropriate. I understand that WISE has no insurance covering such medical or hospital costs incurred for my child; therefore, any cost incurred for such treatment shall be my sole responsibility. This release will remain as long as my child is attending WISE Academy.

Date *

MM/DD/YYYY

Credit Card Recurring Payment Authorization Form

Schedule your payments to be automatically charged to your credit card. This ensures the timeliness of your payments and helps to avoid late charges.
Recurring payments authorizes regularly scheduled charges to your Visa, MasterCard, American Express, Discover card, or Bank Account. You will be charged each billing period for the total amount due for that period. A receipt will be emailed to you and the charge will appear on your credit card or bank statement. You agree that no prior-notification will be proovided.

If Bank Account Selected:

I authorize the above named business to charge the credit card/ bank account indicated in this authorization form according to the terms outlined above. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. This payment authorization is for the type of bill indicated above. I certify that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form.

Date *

MM/DD/YYYY

Payment Plan Options

See 2018-19 Tuition Worksheet for details

Select One *

Payment in Full by August 31, 2018

Plan A - 2 installments ($200 fee): Final Payment due by 11/5/18

Plan B - 4 installments ($300 fee): Final Payment due by 12/5/18

Plan C - 6 installments ($400 fee): Final Payment due by 12/5/18

Plan D - 8 installments ($500 fee): Final Payment due by 01/05/19

Signature Required:

By signing below, I acknowledge the following:

1) $750 is due upon registration (+ $100 application fee if student is new).
2) If selecting payment in full option, payment in full must be received by August 31, 2018 in order to waive convenience fee.
3) 25% of total tuition due May 5, 2018.
4) I must adhere to payment plan chosen upon registration and will be charged a $50 late fee if a payment is missed/late.
5) I must pay a $100 volunteer fee which will be refunded after 10 hours of parent workshops/volunteer hours has been met. *

1) A non-refundable tuition deposit of $500 is required to secure a place for each child attending WISE Academy.
2) I must meet all payments that are established by WISE Academy (listed below) or my account will be charged a $50 late fee per occurrence. I fully acknowledge that my failure to pay tuition when due could affect my child/ren's enrollment status. I hereby fully understand and acknowledge that my child/ren's school records/transcripts will be held until payment is made in full and I hereby fully waive any right or entitlement to said record and fully discharge and forever release WISE Academy from any and all liability for refusing to release said record/transcripts for my failure to pay funds owed to WISE Academy
3) If I pay by check and it is returned for insufficient funds, my account will be charged a penalty of $35 returned check fee and also a $25 late fee.
4) If I have any outstanding tuition balance, I will not be able to enroll for the following school year until I fulfill my obligation(s) and I may risk student losing registration/enrollment status.
5) I understand that this is a fully and legally binding document and that upon signing and submitting this Tuition Policy/Contract a place will be reserved at WISE Academy for the above named student/s for the 2018-2019 school year.
6) I understand that if I have a past due balance on my child/ren's account, WISE Academy will not release any records including report cards and transcripts until the amount is paid in full.
7) If I should decide to withdraw my child/ren after signing this Tuition Policy/Contract I understand that I am still responsible for the full tuition for the 2018-2019 school year.
8) If my child/ren is expelled for violating school policy, I understand I am still responsible for the full tuition for the 2018-2019 school year.
9) Students that do not report to school within the first week of school, without making prior arrangements with WISE Academy Administration, will forfeit their placement in the Academy. *

By signing this form, I am agreeing and accepting the rules and regulations of WISE Academy. I accept the responsibility that I must meet my financial obligations as stated above. I certify that WISE Academy will not be held responsible for any circumstances beyond its control that affects its ability to reserve the above student/s placement. *